This proposal describes the career development activities that the applicant will conduct in order to prepare him to be an independent researcher in cancer etiology, prevention, and control. The focus of this proposal is the early diagnosis of cancer with emphasis on physician's delivery of cancer early detection regimens, elderly adults response to cancer symptoms, and populations at high risk for cancer. Given this focus, the applicant will work closely with an Advisory Committee composed of Doctors David Schottenfeld, Dean Brenner, Max Wicha, Marshall Becker, Toni Antonucci, and Mindy Smith. The applicant has excellent basic research skills, but has identified areas of knowledge and skills requiring more advanced training. the applicant will broaden and advance his research skills through advanced courses in epidemiology and biostatistics offered by graduate programs in the School of Public Health and the Institute of Social Research at the University of Michigan. The applicant will finalize the career development activities through the completion of three studies. These three studies serve to provide experience in planning, implementing, completing, and summarizing research projects under the guidance of seasoned researchers. The three studies proposed are: 1) A prospective clinical trial of 21 primary care practices randomized to 3 intervention groups consisting of patient-held cancer guides, patient chart flow sheets, and usual practice standards. The goal is to evaluate the effectiveness of the interventions on improving acceptance, maintenance, and quality of cancer early detection regimens by primary care practices. 2) Evaluation of social support networks impact on elderly adults response to cancer suspicious symptoms or diagnosed with cancer. The study will utilize data previously collected on the issue of social support and symptoms. The respondents with current cancer suspicious symptoms (n-41) or diagnosed with cancer (n=19) will be the source of the data to address the issue. 3) Meta-analysis review of previous studies on etiologic differences, molecular/genetic predisposition dissimilarities, risk differences, and socioeconomic differences between racial and ethnic groups. This will allow for efficient planning of future studies into an area of prevention and control among ethnic and minority groups who suffer some of the highest morbidity and mortality from cancer. The completion of the didactic courses and research projects proposed along with the interaction with the Advisory Committee will provide the necessary development of the applicant to be an independent researcher.